§ 27-19-55 - Coverage for early intervention services. - Rhode Island Statutes

SECTION 27-19-55

   § 27-19-55  Coverage for early interventionservices. – (a) Every individual or group hospital or medical expense insurance policy orcontract providing coverage for dependent children, delivered or renewed inthis state on or after July 1, 2004, shall include coverage of earlyintervention services which coverage shall take effect no later than January 1,2005. Such coverage shall be limited to a benefit of five thousand dollars($5,000) per dependent child per policy or calendar year and shall not besubject to deductibles and coinsurance factors. Any amount paid by an insurerunder this section for a dependent child shall not be applied to any annual orlifetime maximum benefit contained in the policy or contract. For the purposeof this section, "early intervention services" means, but is not limited to,speech and language therapy, occupational therapy, physical therapy,evaluation, case management, nutrition, service plan development and review,nursing services, and assistive technology services and devices for dependentsfrom birth to age three (3) who are certified by the department of humanservices as eligible for services under part C of the Individuals withDisabilities Education Act (20 U.S.C. § 1471 et seq.).

   (b) Subject to the annual limits provided in this section,insurers shall reimburse certified early intervention providers, who aredesignated as such by the Department of Human Services, for early interventionservices as defined in this section at rates of reimbursement equal to orgreater than the prevailing integrated state/Medicaid rate for earlyintervention services as established by the Department of Human Services.

   (c) This section shall not apply to insurance coverageproviding benefits for: (1) hospital confinement indemnity; (2) disabilityincome; (3) accident only; (4) long-term care; (5) Medicare supplement; (6)limited benefit health; (7) specified disease indemnity; (8) sickness or bodilyinjury or death by accident or both; and (9) other limited benefit policies.